Grocott stain

Recurrent erythematous patches on the extremities of an older patient. Intracorneal microabscess, spongiosis and follicular suppurative inflammation. At the mere whiff of a neutrophil start the search for fungi, and sometimes the rewards are great! #dermatopathology #dermatology

RT @RACARR51: Happy Friday: RAC9012 M72. Cheek BCC. For thoughts & sharing.

Bx UGI / LGI young pt - duodenal Bx (L) with villous atrophy, intraepithelial lymphocytosis + enterocyte damage, ileum (R) with erosive granulomatous ileitis. Coexistent Coeliac and Crohn's. Bad luck but at least highly treatable. Biologics might mimic coeliac but TTG pos #GIPath

Sebaceous glands are really rather exciting, especially when found in the oesophagus (heterotopic or ectopic) - love it when areas of interest collide! #gipath #dermpath

Palisaded encapsulated (solitary circumscribed) neuroma can sometimes be schwannoma-like. Interested to hear others thoughts #dermpath #dermatopathology #pathology.

Bcl6 and Bcl2.

A good prognosis lymphoma to start 2023. Duodenal follicular lymphoma in a pt in 4th decade, endoscopic biopsies of a nodular distorted proximal duodenum. CD3, CD20. #GIPath, #hemepath

Same pt with atrophic metaplastic lymphocytic gastritis + coeliac disease. Tricky to distinguish sites - left atrophic gastric body with pseudopyloric metaplasia and intraepithelial lymphocytes, upper right atrophic antrum + intestinal met, lower right duodenal coeliac. #GIPath

Papular rash on a younger patient. Great when the features all match up in an inflammatory skin Bx. Granular scale, spongiosis, keratinocyte necrosis, intraepidermal red cells (dermal extravasation), wedge shaped perivascular dermal inflammation. PLEVA. #dermpath #dermatology

When Barrett's oesophagus is more inflamed (on histology) than usual, I check for Helicobacter, and this is why! Wonder how often it is present? #GIPath #endoscopy

Middle aged male with papules on limbs. Another Scabies mite to add to #pathtwitter! Seen several lovely examples here recently. Don't forget to order deepers / levels if superficial perivascular lymphocytic / eosinophilic inflammation, to avoid missing the diagnosis. #dermpath

Nice bit of sharp demarcation between dysplasia and non-dysplastic mucosa in a sessile serrated lesion. Nice when it's not difficult! #GIPath.

RT @Mvgs1706: CMV can show a spectrum of histological changes - from ulcers, numerous apoptosis and even ischemia due to vasculitis. This i….

Eosinophilic oesophagitis is a satisfying diagnosis to make, both for morphological thrills and patient outcomes. I particularly enjoy the fibrotic lamina propria, indicated here. #GIPath

Bx of a nodule on an extremity of an older male. Low power imparts a naevoid appearance I thought, but higher power and IHC (take a guess which this is) tells a different picture. #dermpath # BSTPath

Periorbital tumour in an older male. Basosquamous carcinoma. High risk BCC variant. Note perineural invasion in subcut nerve >0.1 mm (red arrow), venous invasion (blue arrow) and positive deep margin. Would recommend Mohs micrographic surgery. #dermpath #dermatology #pathology

Older patient with anaemia ?gastritis. H&E and CDX2 IHC. Bit of a surprise to the endoscopist I suspect. Diffuse type gastric adenocarcinoma. #GIPath

Older patient with anaemia and gastric erosions. Iron pill gastritis. I used to request Perls but stopped after it was so reliably positive it felt like overkill. #GIPath

PRAME positive, I hope you'll agree. Previously described, although I haven't seen a case before. #dermpath , #dermatology, #pathology